[Use of the "pronation worm" in the early functional active-conservative treatment of lateral ligamentous rupture of the ankle].

The "pronation worm", a method of early functional active conservative treatment for sprained ankle, is presented. In our department 75 patients were treated with this method with great success. Recent lateral tears in the ankle were confirmed by stress X-ray examinations, and according to these the patients were divided into two groups: group 1, containing patients with opening of the joint gap to 10-14 degrees (one-ligament injuries); and group 2, containing those with opening to 15 degrees or more (more-ligament injuries). The patients were required to wear ankle boots with a "pronation worm" for 6 weeks though they could take them off to get bathed, clean the boots and at bedtime. They were also asked to perform muscle training exercises for the peroneus muscles three times a day. The clinical-radiological evaluation showed complete healing in 97.3% after 6 weeks and after 6 months, and the stress X-ray photographs confirmed that there was no pathological opening of the joint gap (this applies to all patients in group 1 and 46 in group 2). In two patients in group 2 (2.7%) the X-ray pictures revealed pathologic opening of the joint-gap, but these patients had no subjective symptoms. These preliminary results suggest that recent tears of the lateral ligament ankle should be treated with this early functional active conservative method, i.e. without a surgical operation.